Respiratory device with variable expiratory pressure resistance

ABSTRACT

A device to permit more efficient breathing by medical patients comprising a mouthpiece having a passage portion for communication with the patient&#39;&#39;s mouth and inlet and outlet passages communicating with the first passage portion. The inlet and outlet passages are provided, respectively, with inlet and outlet check valves. A flexible conduit extends from the outlet check valve portion of the mouthpiece to a receptacle containing a liquid and the outlet end of the flexible conduit is immersed in the liquid to an adjusted depth to interpose a predetermined variable fluid resistance to air flow from said mouthpiece outlet passage by way of said conduit.

United States Patent 1 Milch I [111 3,710,780 [451' Jan. 1 ,1973

[541 RESPIRATORY DEVICE WITH VARIABLE EXPIRATORY PRESSURE RESISTANCE[76] Inventor: Robert A. Milch, 1405 North Forest Rd., Buffalo, NY 1422122 Filed: Aug.5. 1971 211 Appl.N0.: 169,252

[52] U.S. Cl ..128/25 R, 272/57 F [51] Int. Cl. ..A6lh 1/02 [58] Fieldof Search ..l28/2, 25 R; 272/57 R, 57 F {56] References Cited UNITEDSTATES PATENTS 3,511,228 5/1970 Lundgren et al ..l28/25 R FOREIGNPATENTS OR APPLICATIONS 779,571 l/l935 France ..272/57 F PrimaryExaminef-Lawrence W. Trapp Attorney-Conrad Christel et al.

[57] ABSTRACT A device to permit more efficient breathing by medicalpatients comprising a mouthpiece having a passage portion forcommunication with the patients mouth and inlet and outlet passagescommunicating with the first passage portion. The inlet and outletpassages are provided, respectively, with inlet and outlet check valves.A flexible conduit extends from the outlet check valve portion of themouthpiece to a receptacle containing a liquid and the, outlet end ofthe flexible conduit is immersed in the liquid to an adjusted depth tointerpose a predetermined variable fluid resistance to air flow fromsaid mouthpiece outlet passage by way of said conduit. I v Claims, 1Drawing Figure PATENTED JAN 1 6 I975 INVENTOR v ROBERT A. MILCH lllll|lllllllllll|||l|||lll ATTOR N EYS RESPIRATORY DEVICE WITH VARIABLEEXPIRATORY' PRESSURE RESISTANCE BACKGROUND OF THE INVENTION Thisinvention relates to apparatus particularly for use by patients withrespiratory problems, as for instance, post-operative patients, andthose with atelectasis, pneumonia, chronic bronchitis, and emphysema.

In certain medical cases patients tend to breathe shallowly, clear theirpulmonary secretions poorly, or have some obstruction to satisfactoryoxygenation of their blood, and there is a need to promote moreefficient breathing. Present methods with this end in view are makeshiftand unsatisfactory. For instance, there is what is known as arebreathing device wherein the patient inhales from and exhales into aclosed chamber, such as a bag. Since the air supply thus availableincreases rapidly in carbon dioxide content, and lowers in oxygencontent, the patient must breathe more to survive. However, it usuallyresults in the patient breathing faster rather than deeper,-and thistechnique is actually dangerous in some cases due to the limited oxygensupply.

In another method the patient uses a mouthpiece for breathing and forcedblasts of air under pressure are introduced into the mouthpiece duringinspiration to promote deeper inhalation. This method is known in themedical arts as intermittent positive pressure breathing and isobjectionable for several reasons: it requires costly and complicatedequipment and trained personnel to administer, it is frequentlyuncomfortable and distressing to the patient, air maybe driven into thestomach instead of into the lungs and secretions may be pushed deeperinto the air passages.

SUMMARY OF THE INVENTION The apparatus of the present invention includesa mouthpiece through which the patient breathes. The mouthpiece has airinlet and outlet portions and the inlet portion is provided with an.inwardly directed check valve which opens freely when the patientinhales to permit inhalation of ambient air for breathing. The outletportion has an outwardly directed check valve which opens freely whenthe patient exhales to permit free passage of exhalation. In addition tothe outwardly directed check valve the outlet portion of the mouthpieceincludes a tube or conduit which leads from just beyond the outwardlydirected expiratoryvalve and has its discharge end immersed in a body ofwater. Thus, upon exhalation, the patient must produce sufficientexpiratory pressure to discharge exhalation from the tube into the bodyof water against the head of liquid which is present between the bottomdischarge end of the tube and the surface of the body of water. Thedepth of immersion of the tube in the water is controlled and adjustableto provide accurately regulated fluid resistance to exhalation.

Thus the patient must exert a predetermined controlled degree ofexpiratory pressure in order to move the exhalation out of the dischargetube and through the head of water. The exhalatory pressure thusgenerated dilates the patients bronchi,.thus permitting better mixtureand absorption of inspired air, and'more efficient clearing of trappedsecretions.

top plan view with portions shown in crosssection for v clearerillustration and an associated receptacle adapted to contain an openbody of water into which the outlet conduit from the mouthpiecedischarges.

DESCRIPTION OF THE ILLUSTRATED EMBODIMENT In the drawing the numeral 1designates a cylindrical valve body having a conduit portion 2 extendingmedially therefrom. A mouthpiece 3 is fitted over conduit portion 2 andhas a mouth-engaging portion 4 with opposed arcuate channels 5 intowhich the patients teeth fit in gripping the mouthpiece orally. Theportion of mouthpiece 3 which fits over conduit portion 2 of valve body1 is preferably of somewhat elastic material so as to stretch over andfit snugly about conduit portion 2.

Valvebody 1 has an inlet' end 6 and an outlet end 7. Inlet end 6 isprovided with a freely flexible disc valve 8 which is fixed medially ina tubular insert 9 by means of a transverse pin 10. The two halves ofvalve 8 may flex freely to the right as viewed in the drawing underexternal air pressure but seat against a bushing or collar 11 under airpressure from within the valve body.

The outlet end 7 of valve body 1 is provided with a freely flexible discvalve 12 which is fixed along a diametral line to a cylindrical insert13 by a transversely extending pin 14. The two halves of valve 12 may 7flex freely to the right as viewed in the drawing under air pressurefrom within valve body 1 but seat against a' collar 15 under pressurefrom the right-hand side of valve 12 as viewed in the drawing.

A flexible conduit 16 extends from the outlet end of valve body 1 and inthe present instance has an enlarged end portion 17 which fits snuglythereovenConduit 16 extends to a receptacle 18 which may comprise agraduated transparent cylinder containing water to a predetermined levelas indicated at 19. The outletconduit 16 from the valve body extendsinto the water 19 and is supported at the upper end of receptacle 18 bya bracket 20 which permits free vertical adjustment of conduit 16 todetermine the depth of immersion of the end of conduit 16 in the water.I

Since the fluid resistance to discharge-of air into the water fromconduit 16 is directly proportional to' thehead of water above thedischarge end of conduit 16, the resistance to discharge of air fromconduit 16, and

consequently from valve body 1,, may be accurately the underlyingprinciples of the invention but it is to be passage for mouth breathing,a check valve in said inletpassage permitting air flow into saidmouthpiece but 2. Respiratory apparatus as in claim 1 wherein said meansfor preventing retrograde fluid flow from said conduit to said outletpassage comprises a check valve in said outlet passage.

3. Respiratory apparatus as in claim 1 wherein said check valvecomprises a flexible disconnected to said inlet passage at oppositediametral points whereby the two halves thereof flex freely in thedirection of fluid flow, and an annular seat portion adjacent to saidvalve at the outer side thereof to the opposite direction.

4. Respiratory apparatus as in claim 2 wherein said check valvecomprises flexible disc s connected to said passages at oppositediametral points whereby the two halves of each valve flex freely in thedirection of air flow, and annularseat portions in said passagesadprevent flexure thereof in 'jace'nt to said valves to prevent flexurethereof in the opposite direction.

5. Respiratory apparatus as in claim 1 wherein said receptacle-isgraduated to show the depth of liquid therein and the depth of immersionof said outlet conduit terminal portion.

6. Respiratory apparatus as in claim 5 wherein said receptacle includesadjustable means for supporting said outlet conduit to support the samefor immersion f to various depths in said liquid.

a a a a: 4 I

1. Respiratory apparatus for conducing more efficient breathing bymedical patients, said apparatus comprising a mouthpiece having an inletand an outlet passage for mouth breathing, a check valve in said inletpassage permitting air flow into said mouthpiece but closable underretrograde flow, a liquid containing receptacle, a conduit leading fromsaid outlet passage and terminating in a portion projecting into theliquid in said receptacle to a predetermined depth, whereby exhalationby the patient through said mouthpiece and said conduit is effectedagainst a liquid head as measured by the depth of immersion of saidoutlet conduit terminal portion in said liquid, and means preventingretrograde fluid flow from said conduit to said outlet passage. 2.Respiratory apparatus as in claim 1 wherein said means for preventingretrograde fluid flow from said conduit to said outlet passage comprisesa Check valve in said outlet passage.
 3. Respiratory apparatus as inclaim 1 wherein said check valve comprises a flexible disconnected tosaid inlet passage at opposite diametral points whereby the two halvesthereof flex freely in the direction of fluid flow, and an annular seatportion adjacent to said valve at the outer side thereof to preventflexure thereof in the opposite direction.
 4. Respiratory apparatus asin claim 2 wherein said check valve comprises flexible discs connectedto said passages at opposite diametral points whereby the two halves ofeach valve flex freely in the direction of air flow, and annular seatportions in said passages adjacent to said valves to prevent flexurethereof in the opposite direction.
 5. Respiratory apparatus as in claim1 wherein said receptacle is graduated to show the depth of liquidtherein and the depth of immersion of said outlet conduit terminalportion.
 6. Respiratory apparatus as in claim 5 wherein said receptacleincludes adjustable means for supporting said outlet conduit to supportthe same for immersion to various depths in said liquid.